[Editor's Note: You can download a PDF of the full revised guidelines.]
The Office of the Medical Director, New York State Department of Health AIDS Institute, is pleased to announce that the Medical Care Criteria Committee, chaired by Barry Zingman, M.D., has updated the guidelines for Selecting an Initial Antiretroviral Regimen.
The following revisions have been made to the table of preferred regimens for initial treatment (see Table 6-A):
- The following agent has been added as an option for a preferred agent:
- Raltegravir (an integrase inhibitor)
- The following agents have been moved from preferred agents to alternative agents (see Table 6-B):
- Zidovudine + lamivudine (Combivir)
- Abacavir + lamivudine (Epzicom)
- Lopinavir/ritonavir (Kaletra)
The guidelines also recommend the following:
- Genotypic resistance testing at baseline and consideration of repeating the test prior to initiating treatment in ART-naive patients
- Patients should be involved in deciding which antiretroviral regimen is most likely to result in adherence
- For women considering pregnancy or not using effective contraception, efavirenz should be avoided
- Clinicians should follow up with patients by phone or visit within 2 weeks of initiating therapy to assess for tolerance and adherence.